Abordagem do Doente com Psoríase pela Medicina Geral e Familiar: Algoritmo de Referenciação e Gestão Partilhada com a Dermatologia

Introduction: The implementation of models capable of improving referral quality, limiting the growth of waiting lists in hospitals, and ensuring the best possible treatment and follow-up of the psoriatic patient is of the utmost importance.Material and Methods: A panel of Family Physicians and Dermatologists discussed and created a simple and effective algorithm of referral for patients with psoriasis.Results: The proposed algorithm starts when the Family Physician suspects of psoriasis. In case of diagnostic doubt, the patient should be referred to Dermatology. In case of a confirmed diagnosis, the Family Physician should assess the patient’s severity and responder profile, evaluate comorbidities and assess the presence of psoriatic arthritis. If psoriasis is mild, topical treatments should be initiated, and if there is no clinical improvement or worsening of the disease, the patient should be referred to Dermatology. If psoriasis is moderate to severe, is located in high impact locations, or in pediatric age, the patient should be referred to Dermatology. In order to enable shared management in terms of follow-up and treatment of these patients, it is critical that the Family Physician has the necessary knowledge regarding the systemic treatments used in psoriasis and their side effects.Discussion and Conclusion: Only a shared management of the psoriatic patient can allow for the best treatment and follow-up of these patients, a more rational use of available medical resources, thus giving the patient the best possible quality of life.

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Evaluation of the Quality of Services in Primary Health Care Institutions

Medicina ◽

10.3390/medicina47010009 ◽

2011 ◽

Vol 47 (1) ◽

pp. 9

Author(s):

Leonas Valius ◽

Daiva Rastenytė ◽

Vilija Malinauskienė ◽

Daina Krančiukaitė-Butylkinienė

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Physician ◽

Family Physicians ◽

Quality Of Services ◽

Primary Health ◽

The Family ◽

Primary Health Care Institutions ◽

Primary Health Care Settings

The aim of the study was to evaluate patients’ satisfaction with the quality of provided services in private primary health care institutions in Kaunas. Material and Methods. A questionnaire-based inquiry of 280 persons registered to family physicians at primary health care settings was performed. The study was carried out using 20-item anonymous questionnaires with questions about the quality of services provided in primary health care settings. Results. More than 50.0% of the respondents stated that they waited for more than 15 minutes at the physician’s office, while 17.0% of the respondents stated that the waiting time exceeded 30 minutes. More than 25.0% of the respondents positively evaluated the possibility to consult their family physician by phone. In 67.0% of patients, the family physician determined the cause of the disorder and administered treatment; in 32.0% of patients, the family physician referred them to a specialist, and 1.0% of patients were urgently sent to hospital. More than 90.0% of the respondents were satisfied with the services provided by their family physicians. Those who were dissatisfied with these services indicated that the provided treatment failed to eliminate the disorder, that they wanted to be referred to a specialist, and that they expected more diagnostic tests to be performed for more effective treatment. Conclusions. A greater part of the patients indicated that the main reason for long waiting at the physician’s office was physicians’ wish to serve too many patients. More than two-thirds (67.0%) of the patients stated that their family physicians determined the cause of the disorder and prescribed treatment. The overwhelming majority (more than 90.0%) of the patients were satisfied with the services provided by their family physicians.

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Factors Affecting the Family Physicians' Intention to Leave the Job: A Case of Iran

The Open Public Health Journal ◽

10.2174/1874944501912010482 ◽

2019 ◽

Vol 12 (1) ◽

pp. 482-488

Author(s):

Rita Rezaee ◽

Pegah Shoaahaghighi ◽

Najmeh Bordbar ◽

Karam Tavani ◽

Ramin Ravangard

Keyword(s):

Organizational Commitment ◽

Family Physician ◽

Family Physicians ◽

Intention To Leave ◽

Work Life ◽

Quality Of Work Life ◽

Factors Affecting ◽

Quality Of Work ◽

The Family

Background: Family physician program is a complete health-care system, and its human resources are the most important resources like any other healthcare program. Organizational Commitment (OC) and Quality of Work-Life (QWL) are important factors in attracting and retaining employees. Objective: To investigate the association of OC and QWL with the intention to leave the job by family physicians in Shiraz, Iran in 2017. Methods: This was a descriptive analytical study conducted on a sample of 268 family physicians in 2017. For data collection, Porter's organizational commitment, Walton's Quality of Work Life, and Cammann's intention to leave the job questionnaires were used. The collected data were analyzed using SPSS 23.0. Results: The results showed that the levels of OC, QWL, and the intention to leave the job were moderate among the studied family physicians. In addition, the results showed that QWL and OC had negative and significant associations with the intention to leave the job (p-value<0.001), and the QWL had a greater association (Beta=-0.348). Conclusion: It is suggested that more attention should be paid to the family physicians at the Ministry of Health and the provincial level to improve the QWL and OC of the family physicians, and thereby preventing the physicians from leaving their job from the family physician program.

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HGG-47. DECREASED GROWTH VELOCITY WITH LONG TERM USE OF BRAFV600e AND MEK INHIBITION IN A PATIENT WITH ANAPLASTIC GANGLIOGLIOMA

Neuro-Oncology ◽

10.1093/neuonc/noaa222.327 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii352-iii352

Author(s):

Hung Tran ◽

Robert Cooper

Keyword(s):

Growth Velocity ◽

Direct Result ◽

Chromosomal Microarray ◽

Mek Inhibition ◽

Follow Up Study ◽

The Family ◽

The Relationship

Abstract PURPOSE To describe decreased growth velocity with long term use of BRAFV600e and MEK inhibition in a patient with anaplastic ganglioglioma. RESULTS 4-year-old patient was found to have a 6 x 4.6 x 5 cm mass in the hypothalamus. Pathology consistent with anaplastic ganglioglioma and chromosomal microarray revealed a BRAFV600e mutation. Patient started on dabrafenib and trametinib and tumor decreased 85% after 3 months. She is stable without significant toxicities 39 months on therapy, and is now 8 years old. Patient had been growing at the 25% for weight and 12% for height but is now 65% for weight and 0.5% for height. It is difficult to tease out the relationship between the tumor, the location of the tumor, and the BRAF and MEK inhibitors and their effect on growth. Discussions with the family and endocrinology are ongoing but being <1% for height will lead to decrease in quality of life. CONCLUSIONS Further follow-up study is needed to determine if this is truly a long-term toxicity, or if this may just be a direct result of the location of the tumor. Would supplementation with growth hormone in this patient lead to losing control of a high grade tumor, or would it simply replace a hormone that is not produced?

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Awareness of Family Physician Residents of their Roles in Disaster Health Management: A Cross-Sectional Study in Saudi Arabia

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i41b32365 ◽

2021 ◽

pp. 254-261

Author(s):

Fawaz Hassan Alamri ◽

Faisal Dhahi Aldahash ◽

Sa’ad Alqahtani

Keyword(s):

Saudi Arabia ◽

Disaster Management ◽

Family Physician ◽

Emergency Services ◽

Health Management ◽

Family Physicians ◽

Cross Sectional Study ◽

Disaster Medicine ◽

Cross Sectional ◽

The Family

Background: Family physicians have a pivotal role in responding to the medical community's needs and have a crucial role in disaster health management. Family physicians have several tasks and duties during and after the disaster, such as event detection, critical information’ collection and distribution, and rehabilitative activities. It is important to identify the level of awareness of the family physicians regarding their role in the management of disasters. Aim: To assess the awareness of family physician residents of their roles in disaster health management, Saudi Arabia. Methods: This study was cross-sectional; it was performed on Saudi family physician residents in family practice clinics and centers in Saudi Arabia. A self-administrated questionnaire has been sent electronically to the participants to investigate their awareness. IMB SPSS version 22 was used to analyze the collected data. Results: This study included 400 family physicians; more than one-half 52.75%were in the age of 28-30 years old. There were 61.5% worked previously at hospital emergency services. A few percentages reported receiving training on disaster medicine management in the clinic, 38.5%. 47.75% reported willingness to train on disaster management. There was 71% of physicians had high knowledge regarding their role in disaster management. Conclusion: There was high awareness among the family physicians regarding their role in the management of disaster with an acceptable attitude toward receiving training.

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THE FAMILY PHYSICIAN IN FOLLOW-UP PROGRAMS

Psychiatric Services ◽

10.1176/ps.8.8.18 ◽

1957 ◽

Vol 8 (8) ◽

pp. 18-19

Author(s):

Charles E. Goshen

Keyword(s):

Family Physician ◽

The Family

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Clinical Holistic Medicine: Applied Consciousness-Based Medicine

The Scientific World JOURNAL ◽

10.1100/tsw.2004.8 ◽

2004 ◽

Vol 4 ◽

pp. 96-99 ◽

Cited By ~ 5

Author(s):

Søren Ventegodt ◽

Joav Merrick

Keyword(s):

Quality Of Life ◽

Medical Treatment ◽

Family Physician ◽

Holistic Medicine ◽

Doctor Who ◽

The Family ◽

Biomedical Treatment ◽

Based Medicine ◽

The Village

Consciousness-based medicine is our term for a form of medical treatment that works by direct appeal to the consciousness of the patient, in contrast to modern biomedical treatment where drugs are used to affect body chemistry. With this concept, maybe we are (in a sense) turning back to the “old medicine”, where the family physician was the all-concerned “old country doctor” who knew the child, the siblings, the parents, the family, and the village. In a series of papers on clinical holistic medicine, we would like to present the classic art of healing, where the physician works mostly with his hands, then show how the modern biomedical physician performs with biochemistry, and finally introduce consciousness-based medicine. Some of our questions will be: If you improve your quality of life, will you also improve your health? Will learning more about yourself bring more purpose in your life? Will finding someone to live with in a loving and mutually respectful relationship improve your health? Scientists and thinkers like Antonovsky, Frankl, Maslow, and Jung have pointed to love as a unique way to coherence in life, and thus to biological order and a better health. Several scientific studies have also suggested that patients who focus on improving their quality of life usually will not follow the general statistics for survival, since somehow other factors are at play, which sometimes you will find referred to as “exceptional”.

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Organization of psychological activities in italian cardiac rehabilitation and prevention Survey on the implementation of guidelines for psychological activities in cardiac rehabilitation and prevention

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2008.430 ◽

2016 ◽

Vol 70 (1) ◽

Author(s):

Marinella Sommaruga ◽

Roberto Tramarin ◽

Gianluigi Balestroni ◽

Ornella Bettinardi ◽

Massimo Miglioretti ◽

...

Keyword(s):

Cardiac Rehabilitation ◽

Psychological Assessment ◽

Comprehensive Evaluation ◽

Psychological Intervention ◽

Eating Behaviour ◽

Educational Interventions ◽

Staffing Level ◽

The Family

The present study was developed as part of a comprehensive evaluation of the state of the art of knowledge and implementation of the Italian Guidelines for psychological activities in Cardiac Rehabilitation, published in 2003 by the Working Group of Psychology of the Italian Society of Cardiac Rehabilitation (GICR). Methods. A questionnaire was designed to collect detailed information on facilities, organization, staffing level, professional background and activities carried out by psychologists working in Italian Cardiac Rehabilitation Units (CRU). Out of 144 Italian CRU (inventory 2004), 107 reported structured psychological programmes. The questionnaires were sent by conventional mail to the referring psychologist of these 107 CRU; they were invited to participate in the survey on a purely voluntary basis. Results. Responses were received from 70 (65.4%) of 107 CRU. 55 CRU (79.8%) report a good knowledge of the published GL; 10.1% declare that the psychologists did not know the current GL. 84.5% consider the GL to be fully applicable, while 15.5% believe that they are only partly applicable. Psychological assessment is performed through clinical interview (94.3%) and psychometric tests (81.4%). 92.8% of the CRU use screening instruments in order to evaluate psychosocial risk factors, in particular anxiety and depression (64.3%). Quality of life (22.8%) and cognitive impairment (17.1%) are not routinely assessed. Educational interventions are planned in 87.1% of the CR programme and are extended to the family members (51%) as well as counselling (57%). Psychological programme includes smoking (56%) and eating behaviour (55%) group interventions. Stress management is routinely planned in 69% of the CRU. Psychological intervention tailored to individual needs of the patients is performed in 62.9% CRU. Written final reports are available in 88.6% cases. The follow-up is carried out by 48.6% of the CRU, 15.7% in a structured way. Conclusions. The survey shows wide discrepancies in the provision of psychological activities in Italian CRU. Nevertheless psychological assessment and interventions seem acceptably coherent with current national GL on CR.

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For Early Breast Cancer, Family Physicians Shown to Provide Same Quality of Long-term Follow-up Care as Specialists

Oncology Times ◽

10.1097/01.cot.0000294582.85573.96 ◽

2006 ◽

Vol 28 (7) ◽

pp. 7-9

Author(s):

Eric T. Rosenthal

Keyword(s):

Breast Cancer ◽

Early Breast Cancer ◽

Family Physicians ◽

Breast Cancer Family ◽

Cancer Family ◽

Follow Up Care ◽

Long Term Follow Up

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Hivatással és hálapénzzel kapcsolatos vélekedések a magyarországi családorvosok és családorvos rezidensek körében

Orvosi Hetilap ◽

10.1556/650.2016.30539 ◽

2016 ◽

Vol 157 (36) ◽

pp. 1438-1444

Author(s):

Péter Torzsa ◽

Dalma Csatlós ◽

Ajándék Eőry ◽

Csenge Hargittay ◽

Ferenc Horváth ◽

...

Keyword(s):

Family Medicine ◽

Quantitative Study ◽

Family Physician ◽

Health Sector ◽

Family Physicians ◽

Payment Method ◽

Informal Payment ◽

The Family ◽

Two Generations ◽

Human Resource Crisis

Introduction: The changing of the family medicine can be observed in the New Millennium. Migration, the aging of the healers and informal payment are crucial to the human resource crisis of the health sector. Aim: The aim of this study was to investigate the family physicians’ and residents’ opinions about the vocation and informal payment. Method: Exploratory, quantitative study was carried out among family physicians (n = 363) and family physician residents (n = 180). The central questions of the study were the vocation, the income and the informal payment. Results: The most decisive factors of the carrier choice were altruism, service and responsibility. Residents were significantly rejective (19.7% vs. 38.3%, p<0.001) about informal payment. They would accept smaller amounts of informal payment (14.3% vs. 8.9%, p<0.034), and would spend it on praxis development (1.4% vs.9.4% p<0.023). Conclusions: The attitudes of family physicians and residents are the same in case of the vocation, but on the issue of informal payment, the two generations have different opinions. Orv. Hetil., 2016, 157(36), 1438–1444.

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